Dissociative
Identity Disorder (DID)

Dissociative Identity Disorder (DID), previously known as Multiple Personality
Disorder (MPD) and other Dissociative Disorders have caused much controversy
in the medical community, especially with the advent of books and movies
about people with repressed or forgotten memories of childhood abuse and
multiple personalities numbering 10 or more. These disorders are now commonly
recognized as the effects of severe trauma in early childhood, typically
extreme, repeated physical, sexual or emotional abuse. Though some doctors
feel that caution is required to avoid ‘leading’ the patient
to remember things that did not happen, or to ‘create’ alternate
identities, in all but the most extreme and unusual cases neither of these
concerns apply. Mild dissociation is like daydreaming, or getting lost
in a good book, or driving down a familiar stretch of road and finding
that you’ve forgotten the last few miles of the drive. Severe and
chronic dissociation differs from what most of us experience in these
examples. Dissociative Identity Disorder, previously called Multiple Personality
Disorder, and other Dissociative Disorders result in broken connections
between thoughts, memories and sense of identity. Other dissociative disorders
include psychogenic amnesia where the patient is unable to recall personally
significant memories, psychogenic fugue with memory loss characteristic
of amnesia, loss of identity, and fleeing home environment, and Dissociative
Identity Disorder, where the patient appears to have two or more distinct,
alternating personalities. Dissociation is typically a psychological defense
mechanism that has psychobiological.phpects. Research seems to illustrate
that this process is initially used to deflect traumatic experiences and
allow the patient to handle trauma, and that it evolves over time into
a pathological process. The disorders most often occur in childhood, when
a child is subjected to trauma. Children who learn to disassociate to
endure extended abuse will often use this coping mechanism in response
to any stress they endure during their adult life. On rare occasions,
adults may develop dissociative disorders because of severe trauma.

Two or more ‘personalities’ with only one of the
personalities present at any given moment, and one of them dominant
most of the time. Personalities are discrepant and seem to be
opposite, original personality has no knowledge of the other(s).
When a personality is interacting with the environment, other
personalities may not know what is happening. Each personality
has unique memories, behavior patterns, and relationships. Transition
from one personality to another is sudden, and usually in response
to stress.

How is it diagnosed and treated?

The primary problem in diagnosing DID is the confusion regarding dissociative
disorders and the effects of psychological trauma, and misconception about
the clinical.phpects of the diagnosis. DID is relatively common but patients
may minimize or conceal symptoms, or symptoms can be coincident with post-traumatic
stress disorder, depression, panic, and eating disorders and therefore the
doctor may miss the signs of DID. The American Psychiatric Association defines
the diagnostic criteria for DID, as follows:

The presence of two or more distinct identities or personality
states (each with its own relatively enduring pattern of perceiving,
relating to, and thinking about the environment and self).

Inability to recall important personal information that is too
extensive to be explained by ordinary forgetfulness.

At least two of these identities or personality states recurrently
take control of the person's behavior.

The disturbance is not due to the direct physiological effects
of a substance (e.g., blackouts or chaotic behavior during Alcohol
Intoxication) or a general medical condition (e.g., complex partial
seizures). In children, the symptoms are not attributable to imaginary
playmates or other fantasy play.

Treatment(s) can include:

Psychotherapy

Hypnotherapy or Pentothal, if appropriate to recover memories

Eye Movement Desensitization and Reprocessing (EMDR) if appropriate

Cognitive Behavioral Therapy

Hospitalization in severe cases

Medication as appropriate: antidepressants, anti-anxiety medication

Specially designed questionnaire tools to identify specific
symptoms for treatment

Statistics

It is estimated that 3% of American adults are affected by DID.
Up to 7% of the adult U.S. population may have suffered from a Dissociative
Disorder at some time, but since this disorder often goes unrecognized,
it is difficult to estimate the prevalence.

Studies show that 97% of patients with DID have a history of childhood
abuse In 75% of the cases, sexual abuse, usually incest, was reported

DID most often occurs in early childhood, from age 2-8.

Dissociative Amnesia and Depersonalization Disorder generally occur
in adulthood or adolescence, but it has been diagnosed in children.

Five times more women than men suffer from Dissociative Identify
Disorder.

Transient and mild dissociative experiences are common among the
general population. In a recent survey, nearly 1/3 of the people
questioned said they sometimes feel as though they are watching
themselves in a movie, 4% say they feel that way as much as 1/3
of the time. The prevalence is highest in adolescents and steadily
declines after the age of 20.

Posttraumatic Stress Disorder (PTSD), affects 8% of the general
population in the United States, and is closely related to Dissociative
Disorders. In fact, 80-100% of people diagnosed with a Dissociative
Disorder also have a secondary diagnosis of PTSD.

If you are in a crisis please call:
1-800-SUICIDE (784-2433) or
1-800-273-TALK (8255)

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